What is Health Anxiety

People with good physical health or people diagnosed with health conditions equally can develop health anxiety.

Health anxiety is characterised by preoccupation and fear that the person or someone close has a severe illness. The concerns can be either regarding the present moment or in the future. They cause significant stress, which may affect day-to-day functioning. The fear of serious illness can lead to repetitive checking for signs of illness and not feeling reassured by negative medical results. Worrying can often escalate to uncontrollable levels and may make the symptoms worse.

What causes Health Anxiety

There is no specific single cause for health anxiety. Some people are more vulnerable because of particular life experiences like past serious illness, recent experience or proximity to physical/ mental illness or death (especially if such exposure has not happened during childhood), stress, changes in appearance, predispositions for emotional sensitivity, sensitivity to anxiety and uncertainty and others. Not everyone who may have the above vulnerabilities develops health anxiety.

The most common symptoms of Health Anxiety are:

• Concern and preoccupation with the idea of having a severe condition or illness

•  Spending significant time worrying about one's own (or someone close) health

• Feeling anxious, scared, worried, tired, and unwell

•  Hypervigilance about body changes, sensations or symptoms -repetitive checking and monitoring for signs, such as checking pulse, blood pressure, temperature, palpitating body several times a day and others

• Repetitively seeking medical evaluation due to worries about what doctors may have not found or reassurance seeking from others or the internet

•  Avoiding situations which might provoke anxiety, such as medical programmes on TV, hospitals, people with health conditions, etc.

•  If there is a present verified medical condition, the anxiety and fear feel out of control

•  The source of anxiety sometimes may shift from one illness to another, e.g., fear of appendicitis will be superseded by fear of bowel cancer

What maintains Health Anxiety going

• Threatening interpretations of thoughts or body symptoms

• People struggling with health anxiety tend to interpret fearful signs as evidence of severe conditions, physical sensations like bowel movements, pain, fatigue, swelling, or a new mole as a threat of having cancer.

• Safety behaviours like repetitive reassurance seeking, repetitive monitoring and checking of physical symptoms, distraction of suppressing thoughts and others. Safety behaviours give short-term relief, but the effect does not last long.   

Treatments

Only a doctor or mental health professional should diagnose health anxiety, and this is usually if the symptoms associated with health anxiety persist for at least six months, have caused significant distress, or have negatively affected an individual's daily life.

Psychological treatments for health anxiety include:

• Cognitive Behavioural Therapy (CBT)

•  Acceptance and Commitment Therapy (ACT).

Medication for reducing the symptoms of health anxiety shows less effectiveness than CBT and ACT.

References:

American Psychiatric Association. (2022). Bipolar and related disorders. In Diagnostic and statistical manual of mental disorders (5th ed., text rev.)https://doi.org/10.1176/appi.books.9780890425787.x05_Anxiety_Disorders

International Classification of Diseases, Eleventh Revision (ICD-11), World Health Organization (WHO) 2019/2021 https://icd.who.int/browse11. Licensed under Creative Commons Attribution-NoDerivatives 3.0 IGO licence (CC BY-ND 3.0 IGO).

https://www.psychologytools.com/resource/understanding-health-anxiety/

https://www.nhs.uk/mental-health/conditions/health-anxiety

https://slam.nhs.uk/hypochondria-health-anxiety